Morton's neuroma medical therapy
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Morton's neuroma Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2]Faizan Sheraz, M.D. [3]
Overview
Non-surgical treatment is instituted first.
Medical Therapy
- Non-surgical treatment is instituted first
- Physician may recommend any of the following:
Conservative therapy for Morton's neuroma
- Morton's neuroma should be managed conservatively before proceeding to expensive diagnostic procedures
- Conservative measures for pain relief include:
- Decreasing pressure on the metatarsal heads by using:
- Metatarsal support
- Metatarsal bars
- Metatarsal pads
- Padded shoe insert (it's important to place inserts properly just proximal to the metatarsal head)
- Tapping the toe area
- Orthotics
- Specialized orthopedic shoes
- Shoes with wider toe boxes allowing spread of metatarsal heads
- Determine proper shoe width while standing with the help of a professional shoe fitting device
- Physical therapy
- Strength exercises for intrinsic foot muscles
- Decreasing pressure on the metatarsal heads by using:
Non-conservative medical therapy
- When conservative measures fail, following medical therapy is used for non-surgical treatment of neuroma:
- Tricyclic antidepressants
- Anticonvulsants (more effective)
- Serotonin-norepinephrine reuptake inhibitors
- Ultrasound-guided interdigital injection of following nerve blocking agents via dorsal approach into the site of tenderness:
- Steroid
- Local anaesthetic
- Anti-inflammatory drugs (orally or injected into the toe area )
- Painkillers (not recommended for long-term treatment)